Actinic keratosis diagnosed in almost one-third of older adults (Treatable pre-cancer)

Medical Xpress / JAMA Dermatology ^ | August 16, 2022 | Lucy J. Navsaria et al,

[ConservativeMind]

Nearly three in 10 Medicare beneficiaries have at least one actinic keratosis diagnosis encounter over five years of follow-up, according to a research letter published online July 27 in JAMA Dermatology.

Lucy J. Navsaria, M.B.B.Ch., from University of Texas MD Anderson Cancer Center in Houston, and colleagues used Medicare claims data (2009 to 2018) to identify beneficiaries without Medicare Advantage coverage (fee-for-service only) but with continuous Parts A, B, and D coverage. The authors sought to examine incidences and treatment patterns associated with actinic keratosis.

The researchers found that 29.3 percent of beneficiaries had one or more actinic keratosis diagnosis encounters. Of 8.18 million actinic keratosis diagnosis encounters (mean of 5.59 per patient), most occurred with dermatologists (78.6 percent) and physician assistants or nurse practitioners (10.4 percent). Topical fluorouracil was used in 2.3 percent of encounters. The raw incidence rate of actinic keratosis diagnosis encounters with treatments was higher for men versus women and for White patients versus all other race and ethnicity groups.

"Actinic keratosis is a major public health problem for U.S. older adults," the authors write. "The findings demonstrated high incidence rates and suggested an opportunity for squamous cell carcinoma prevention through increased use of topical fluorouracil."

[ConservativeMind]

Topical fluorouracil is cheap, even without insurance.

GoodRX shows it for as little as $38 at a store pharmacy near me.

Get checked and apply the ointment. There’s no need for what it progresses into.

[ConservativeMind]

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[Wally_Kalbacken]

Was given Fluorouracil treatment about 20 years ago. For one month you apply it topically. In the initial week you sort of wonder if it is working because you do not see any changes. Then your skin starts to glow bright red and for 2-3 weeks you look like you have fallen asleep in a tanning bed turned up to 11. Then for a period of about a month, your skin molts. Just flakes off. Much fun.

[Glad2bnuts]

I do not understand this article or post even just a little.

[ConservativeMind]

A large number of retired people have precancerous legions they are not getting checked or treated. The treatment would eliminate a prime source of at least three skin cancer types.

[steve86]

Topical application of CBD oil causes actinic keratoses to self-destruct, breaking up into particles and flakes that rinse away. I thought I discovered this; but turns out the phenomenon is well known. I have gotten rid of 15-20 this way over seven years.

In pre-CBD days my mother’s shoulders and back were almost entirely covered with AKs yet she didn’t ever develop squamous or other cancer. She made it to 102 and died after a fall.

[MadMax, the Grinning Reaper]

You have to learn to read/speak “medicalese” in order to understand the article.

The medicine works reasonably well but I still cannot say it’s name properly.

[ClaytonForester]

My derm just freezes them. Takes about 3 seconds, doesn’t hurt, and they’re gone in a couple weeks.

[zeestephen]

Let me try to translate this post into plain English.

Actinic Keratoses - aka solar keratoses - are small areas of sun damaged skin.

As people age, the risk increases that sun damaged skin will evolve into basal cell or squamous cell cancer or even melanoma.

The risk is low - perhaps 5% - and all three skin cancers are massively over-diagnosed, which means you can save a lot of co-pay money by having solar keratoses destroyed when they first appear.

Unless you have extensive areas of sun damaged skin, the best destruction method is NOT fluorouracil (trade name Efudex, which is also used by gay men to treat venereal warts).

The best destruction method is cryo-ablation - freezing with liquid nitrogen.

Cryo-ablation, unfortunately, is a massive money sucking medical scam.

You get charged for a Dermo office call - at least $150 - plus the first ablation is like $250. Additional ablations in the same appointment are cheaper, like $35.

Unless something has recently changed in the Dermo business, skin doctors outside the Sun Belt are NEVER pro-active. They wait until something starts to grow, and then they biopsy it, which can cost mega bucks, especially if they decide it might be melanoma.

[LouAvul]

.

[corkoman]

Over the counter system for freezing stuff on your skin that is acting funny. About 13 bucks.

Good fun!

[moovova]

Exactly.

I have a standing appt with my dermatologist, every six months, for a whole body scan. Mostly, he freezes spots, occasionally biopsies, and every once in awhile...I go under the knife for a deeper removal. He’s also a cosmetic surgeon, so when he cuts...he sews me up nice and pretty. He’s caught several things that, if ignored, could’ve wound up ugly.

[KittyKares]

Does it work? I had a few skin blemishes removed, but boy was it costly, and I don’t think they did such a great job.